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Millon’s model categorizes fifteen personality disorders around a theoretical normal personality, with three variants from normal to abnormal each. In this post, we will provide an initial map of the fifteen categories of personalities described by Millon. Following Millon, we’ll sort them into several categories and subcategories. This way, I can describe the things some personalities have in common, then when I describe them individually I can focus on their contrasting features. After this I put in several tables that summarize and further organize the categories. They are also handy reference tools; there’s simply too much information here to keep in working memory, so having an overview on a single screen is useful.

Interpersonally Imbalanced Personality Disorders

The interpersonally imbalanced refer to those who exhibit dysfunctional behavior that is either excessively focused on others or on oneself. It’s important to note that when I use the term “dysfunctional,” I mean that these behaviors do not serve one’s own interests overall. However, it’s possible for dysfunctional behavior to be perceived as beneficial by the individual, even though it may ultimately lead to negative social consequences. For instance, the behaviors comprising narcissistic personality disorder may feel good for a while because they feed one’s ego, but they often result in social disaster, ultimately feeling worse than a more realistic self-image would have.

The label “interpersonally imbalanced” is used to describe personalities that exhibit dysfunctional cycles of behavior, where they excessively prioritize either their own needs or the needs of others when the behavior becomes pathological. To simplify, one could think of these personalities as either overly selfish or pathologically altruistic, but there is, of course, much more nuance to this concept.

In some literature, personalities that excessively prioritize the needs of others are described as dependent personality disorders, while those who prioritize their own needs are described as independent. However, this categorization can be confusing, as dependent (as in other-oriented) personalities are divided into histrionic and dependent (as in Dependent Personality Disorder) in Millon’s model. The independent (as in self-oriented) personalities are divided into antisocial and narcissistic.

• DAD Spectrum: Deferential/Attached/Dependent Personalities: Individuals with a dependency pathology have learned that they can feel good, secure, and confident by relying passively on the goodwill of others to avoid pain and seek pleasure. They form strong bonds and have a strong need for interpersonal support and attention. However, if they are deprived of social affection and nurturance, they are likely to experience discomfort, including feelings of sadness and anxiety. (Millon 2011 272)
• SPH Spectrum: Sociable/Pleasuring/Histrionic Personalities: People in the SPH spectrum tend to rely on others as their primary strategy. They’re a group of personalities that take an active dependency stance to get what they want, like protection, nurturance, and reproductive success. They do this by engaging in manipulative, seductive, gregarious, and attention-getting behaviors with others. (273)
• CEN Spectrum: Confident/Egotistic/Narcissistic Personalities: According to the theory, individuals with an “independent” personality pattern rely primarily on themselves instead of others. They believe that they can achieve maximum pleasure and minimum pain by minimizing the importance of others and turning passively to a high validation of self. In simpler terms, they prioritize their own needs over others and focus on building a strong sense of self-worth. (273) Those on the CEN spectrum (i.e. those with a passive-independent orientation) tend to do so in ways that range from being confident in oneself just for existing to delusions of grandeur.
• ADA Spectrum: Aggrandizing/Devious/Antisocial Personalities: According to the theory, people with an active-independent orientation are similar to those with the DSM Antisocial Personality Disorder. They have a tough exterior, and sometimes act in socially unacceptable ways to avoid getting hurt by others. They may engage in duplicitous or illegal behaviors to benefit themselves and not care about the consequences for others. They don’t trust others easily, want to be independent, and may seek revenge for past wrongs they’ve experienced. (273)

Note on Egoism, Egotism, and the CEN/ADA Distinction

Narcissism and antisociality are often conflated. For instance, one popular model describes antisociality (also called sociopathy) as an extreme variant of narcissism. At least on the model we’re using, the two are distinct. While both are self-oriented, narcissism is passive whereas antisociality is active. Recall from the post on the passive and active modalities that this means that narcissism involves expecting good things to come to oneself because of a sense of specialness, and antisociality involves expecting to have to modify one’s environment. Both involve prioritizing one’s own interests over those of others, but the narcissistic justification is a belief in one’s being especially deserving of pleasure whereas the antisocial justification is a belief that we live in a brutal world where everyone is out for themselves and so a good life requires acting in self-interest.

The E in the CEN spectrum stands for “Egotistic”. The difference between egotism and egoism conveniently helps further clarify the distinction.

(from PEDIAA)

Both the CEN and ADA spectra can be accurately described as egoistic, but only the CEN spectrum is necessarily egotistic. 

Intrapsychically Conflicted Personality Disorders

The intrapsychically conflicted are split in interpersonal relations and intrapsychic structures. The two kinds here are less symmetrical with each other than the previous two. They are the insecurely ambivalent and the paradoxically discordant. The insecurely ambivalent personality disorders are constituted by a split between aims of independence and dependence. That is, the content of the aims of self and other contradict each other. The paradoxically discordant personalities experience a reversal in their pleasure and pain polarities. They find pleasure in things that most people would find painful, and they avoid things that bring pleasure. This means that they may feel better when things in their life are going wrong, and they may feel worse when things are going well. It’s like they find pleasure in things that are bad for them, and they don’t enjoy things that are good for them.

These patterns of self-conflict, known as “intrapsychic conflict,” can be seen in the way people behave in their daily lives. For those who are insecurely ambivalent, their conflict arises from their perceived tension between their own desires and the desires of others. This makes them feel insecure because they see others as both sources of pleasure and pain. Their actions aimed at benefiting themselves can sometimes contradict their actions aimed at promoting social good, leading to inner turmoil.

The paradoxically discordant also experience this self-conflict in a different way. They find pleasure in things that can be destructive to themselves and others, while things that could enhance their life may be painful for them. This leads to self-destructive and socially destructive behaviors, making it difficult for them to pursue a better life.

Each of these conflicts is influenced by whether a passive or active mode of adaptation is dominant. The negativistic personality disorder is the actively fought conflict of motives between self and other. The compulsive personality disorder is the passive form. Likewise, sadistic and masochistic personality disorders are the active and passive forms of pain-pleasure reversal. 

Emotionally Extreme Personality Disorders

The emotionally extreme personality disorders include those that are affectively impassive and intensely expressive. The affectively impassive include the avoidant and schizoid. The intensely expressive, turbulent and depressive. The avoidant and schizoid are respectively distinguished by their preference for an active or passive adaptation mode. Both have a lack of feeling of pleasure, and avoidants actively avoid external stimulation, possibly hyper-sensitive to pain, while schizoids develop a passive-mode-heavy adaptation strategy as they are desensitized to both pleasure and pain. 

“On what basis can pathology in the level or capacity of either the pain and pleasure polarities be seen as relevant to personality?” (272) 

• AAS Spectrum: Apathetic/Asocial/Schizoid Personalities: These individuals are deficient in both pleasure and pain polarity objectives. That is, “they lack the capacity, relatively speaking, to experience life’s human relationship events either as painful or pleasurable. Without these motivations, they may act passively as social life goes by.” (272) 
• SRA Spectrum: Shy/Reticent/Avoidant Personalities: A group of individuals that experience difficulty with the pleasure-pain polarity have a reduced ability to feel pleasure, but are acutely sensitive to emotional pain. As a result, they often feel that life is burdensome and filled with more suffering than joy. They are hypervigilant and constantly try to avoid situations that might lead to pain. (272)

Following this, those with a hyper-sensitivity to pleasure that develop a dysfunctional hyperfixation on pursuing pleasure are described as having the turbulent personality disorder, and those with the pain version of the same the melancholic personality disorder. 

• EET Spectrum: Ebullient/Exuberant/Turbulent Personalities: These individuals stand out due to their focus on actively pursuing the pleasurable side of the pain-pleasure polarity. They are often energetic and exuberant in demeanor, sometimes to the point of appearing scattered or manic. (272-273)
• DFM Spectrum: Dejected/Forlorn/Melancholic Personalities: These individuals typically experience chronic feelings of sadness and depression, even when objectively things may seem to be going well for them. They are oriented towards the pain polarity, often exhibiting a passive and defeated demeanor. (273)

Structurally Defective Personality Disorders

Finally, the structurally defective include the schizotypal, borderline, and paranoid personality disorders. The schizotypal and borderline involve the dissolution or diffusion of ego capacities, and conversely, the paranoid, overly rigid separation of ego capacities. We categorize them as follows:

• ESS Spectrum: Eccentric/Schizotypal/Schizophrenic Personalities: This personality spectrum is characterized by a significant deficiency in every polarity. Eccentric, Schizotypal, and Schizophrenic personalities have limited capacity to experience pleasure and often struggle to distinguish between self and others in their approach to life. They also have difficulty using active or passive modes of adaptive functioning. As a result, many individuals with these personalities withdraw from social interactions and have few personal connections or obligations. (272)
• MPP Spectrum: Mistrustful/Paranoid/Paraphrenic Personalities: These individuals exhibit a strong mistrust of others and are defensively edgy against anticipated criticism and deception. They are highly sensitive to pain, particularly rejection and humiliation, and are oriented towards self-preservation. As a result, they may exhibit touchy irritability and a need to assert themselves, even if it is only in their inner world of self-determined questionable beliefs and assumptions. (273)
• UBC Spectrum: Unstable-Borderline-Cyclophrenic Personality: This personality spectrum is characterized by emotional dysfunction and maladaptive ambivalence towards the pleasure-pain polarity. They experience conflicts across all three polarities – pleasure and pain, active and passive, self and other. These individuals are unable to maintain a consistent, neutral, or balanced position among these polar extremes and tend to fluctuate from one end to the other. They experience intense endogenous moods with recurring periods of dejection and apathy, which are often interspersed with spells of anger, anxiety, or euphoria. (273-274)

Table of Personality Disorder Categories

The following table summarizes the categorization of personality disorders. It provides a high-level view of the relationships among the personalities, which will be useful as a reference as we go through each spectrum in their own posts.

Table of Personality Spectra

The following table neatly collects the descriptions of the extreme ends of the spectra. 

Spectrum	Description
Deferential/Attached/Dependent (DAD)	• Needy dependency pathology involves a learned reliance on the goodwill of others for feelings of pleasure and avoidance of pain. • Individuals with this pathology tend to form strong bonds with others. • They display a strong need for interpersonal support and attention. • Deprivation of social affection and nurturance may cause them marked discomfort, sadness, and anxiety.
Sociable/Pleasuring/Histrionic (SPH)	• Their primary strategy is to turn to others. • They take an active dependency stance. • They achieve their goal of maximizing protection, nurturance, and reproductive success by engaging in a series of manipulative, seductive, gregarious, and attention-getting maneuvers with others.
Confident/Egotistic/Narcissistic (CEN)	• Exhibit a self-reliant pathology, learning that the pursuit of maximum pleasure and minimum pain is achieved by minimizing the significance of others and relying passively on a naive but highly self-validating perspective.
Aggrandizing/Devious/Antisocial (ADA)	• Actively engage in duplicitous or illegal behaviors to counter the expectation of pain from others. • Seek to exploit others for self-gain. • Skeptical regarding the motives of others. • Desire autonomy and wish revenge for perceived past injustices.
Assertive/Denigrating/Sadistic (ADS)	• The usual properties associated with pain and pleasure are conflicted, discordant, and reversed. • They seek to create painful events for others and experience them as pleasurable. • They consider pain, rather than pleasure, to be the preferred mode of actively relating to others.
Abused/Aggrieved/Masochistic (AAM)	• Engage in relationships that deviate from the normal balance between pleasure and pain • May have developed a preference for pain as an experience in these relationshipsMay passively accept or even encourage pain in intimate relationships
Discontented/Resentful/Negativistic (DRN)	• Oriented toward both self and others, but there is an intense conflict between the two. • Vacillate between giving primacy one time to others and then to self the next. • Behaving obediently one time, and reacting defiantly the next. • Unable to resolve their ambivalence, they weave an actively erratic course.
Reliable/Constricted/Compulsive (RCC)	• These individuals display a consistent other-directedness, conforming to social norms and showing respect in their interpersonal interactions. • Their histories often involve strict parental rules and high expectations, despite their passive outward behavior. • However, beneath this surface behavior lies intense desires to rebel and assert their underlying self-oriented feelings and impulses. • Trapped in their ambivalence, they often struggle to make decisions or take action.
Shy/Reticent/Avoidant (SRA)	• Experience diminished ability to experience pleasure • Have an unusual sensitivity and responsiveness to psychic pain • View life as vexatious, possessing few rewards and much anguish • Are hyperalert and actively seek to avoid the anticipation of pain
Apathetic/Asocial/Schizoid (AAS)	• Deficient in both pleasure and pain polarity objectives • Lack the capacity to experience life’s human relationship events either as painful or pleasurable • Without these motivations, they may act passively as social life goes by.
Ebullient/Exuberant/Turbulent (EET)	• The focus is primarily on pursuing pleasure over avoiding pain. • People with this tendency are typically energetic and upbeat in demeanor. • However, they may become overly animated, scattered, or even manic in their pursuit of pleasure.
Dejected/Forlorn/Melancholic (DFM)	• Chronically experience feelings of sadness and depression • Tend to display passive behavior and a tendency to “give up”
Eccentric/Schizotypal/Schizophrenic (ESS)	• These individuals have a markedly deficient orientation in the pleasure-pain polarity schema. • They experience minimal pleasure to varying degrees. • They have difficulty consistently differentiating between self and other approaches to life and utilizing active or passive modes of adaptive functioning. • Many regress into social isolation with minimal personal attachments and obligations.
Mistrustful/Paranoid/Paraphrenic (MPP)	• Vigilant mistrust of others • Edgy defensiveness against anticipated criticism and deception • High sensitivity to pain (rejection-humiliation) • Oriented strongly to the self-polarity • Touchy irritability • Need to assert themselves, not necessarily in action, but in an inner world of self-determined questionable beliefs and assumptions
Unstable/Borderline/Cyclophrenic (UBC)	• Conflicts exist across all three polarities: pleasure and pain, active and passive, self and other. • Unable to take a consistent, neutral, or balanced position among these extremes, tending to fluctuate from one end to the other. • Experience intense endogenous moods, with recurring periods of dejection and apathy, often interspersed with spells of anger, anxiety, or euphoria.

Personality Spectrum Circulagram

The following circulagram is directly from Millon’s 2011 book. It provides another overview of the personalities. The outermost ring divides the personalities into the categories based on evolutionary orientations. The second and third rings list the normal and disordered personality types. The fourth ring denotes whether the personalities are more inclined to the active or passive mode of adaptation, or a more even mix of both.

(Millon 2011 275)

This categorization has a few notable differences from the one presented thus far in this post. Notice that the structurally deficient and emotionally extreme personalities are distributed into categories with the others. In particular, the Schizotypal personality is here seen as fundamentally similar to the Schizoid and Avoidant personalities in their deficiencies in the pleasure and pain polarities. It’s neither especially passive nor active, but rather having structural deficiencies not shown here. Likewise, the Paranoid personality is fundamentally similar to the other Independent orientations, and the Borderline the other ambivalent orientations. 

How the Turbulent and Melancholic personalities are supposed to relate with the more passive and active types sharing each’s evolutionary orientation is less clear. Here, rather than Turbulent and Melancholic personalities being each other’s counterparts, Turbulent’s counterpart is Paranoid. But perhaps the lack of clarity comes from an unrealistic expectation for the circulagram to show more than it claims to. The parallel between the five passive+active personalities might just be their using a mix of passive and active modalities. What we see here, then, is different from the information and categorization described before.

There’s an important point here: there is no uniquely correct categorization. While it’s important to Millon’s model that these fifteen personality spectra usefully model the range of human personality, how we organize them is a matter of preference. There are a lot of relationships between the personalities, and each method of categorization shows different relationships. Thus it’s useful to explore a wide variety of ways to meaningfully group them.

Table of Pain/Pleasure and Active/Passive

This last table displays the information we looked at in the circulagram and presents it a bit more simply.

What’s Next?

I’m going to write posts on each of these spectra. Are there any you especially want to see? What do you want to know about these personalities? Let me know in the comments.